PubMed Health⌕ Search

Biomedical subjects

D Wilsford

Publications and source records attributed to D Wilsford.

4 recordsLinked to original sources
PubMed1995

States facing interests: struggles over health care policy in advanced, industrial democracies.

Given alarming fiscal imperatives, states and interests in all advanced industrial democracies have struggled over health care policy. I explore the interface between state autonomy in health care policy and the political mobilization of provider interests, especially physicians. Evidence from Germany, Japan, Canada, and Great Britain suggests that, longitudinally, policy makers everywhere have tried to increase state autonomy in health care, and this has generally triumphed over even effectively mobilized providers. The countries that have most successfully restrained the growth of health care expenditures--while still providing ready access to relatively high-quality care--are those where states have most actively restrained both demand- and supply-side system interests in policy making. In each country, states have increasingly articulated their own greater capacities in health care policy, pushed to do so by the imperatives, especially fiscal, embedded in the policy domain.

Attitude of Health Personnel↗
PubMed1987

The cohesion and fragmentation of organized medicine in France and the United States.

The French and American medical professions share similar historical bases for strong political and economic market positions. As professions, the attributes of common education, ethics, and mission tend to keep physicians together in their political organization. But the medical professions in both France and the United States are also subject to intraprofessional forces of division, such as the conflicts which often oppose generalists to specialists. Although organized medicine in France and the United States shares these commonalities, there is a very important difference between the two countries. The French profession tends toward organizational particularism, both ideologically and nonideologically, which serves to splinter it in ways inimical to the interests of the medical profession. By contrast, the American medical profession tends to organize universally-that is, its organizational base is much more often one of unity and accommodation toward the divergent interests of physicians. Thus, organized medicine in the United States has more easily fought off political and economic pressures coming from government and the private sector-but by no means with total success. On the other hand, highly fragmented organized medicine in France has experienced an almost linear decline in the face of pressures coming from a determined and strong state.

American Medical Association↗